Job Details
Provide expertise and claims support to the team in reviewing, researching, investigating, processing and adjusting claims. Review all quality errors for the team identifying coaching opportunities and rebuttals. Provide chair side coaching and mentoring to address skill gaps. Mentor new CF - Rs to reduce the training curve and improve quality. Assist with CFR questions to increase CFR knowledge and team quality. Ensure P&Ps are read and understood by the team. Monitor IEX as back-up to the supervisor to assist with team production and to identify if coaching or assistance is needed. Process claims according to specific procedures and standards, meeting all positions production, quality, and standards. Review manually entered claims. Review CSI tickets with CFR prior to submission Review claim quality errors with the CF - Rs Assist the Supervisor with workforce management tasks and follow up. Applies knowledge/skills to activities that often vary from day-to-day. Requires little assist...Customer Service Representative, Customer Service, Lead, Behavioral Health, Representative, Remote, Retail